迷你透皮利切除 vs 柔性尿路透镜用于1-2厘米的下极结石:一个随机对照试验
Hazem Elmansy1, Moustafa Fathy1,2, Amr Hodhod3
1Urology Department, Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
BJU international
|October 23, 2024
概括
与灵活尿道镜检查 (f-URS) 相比,无管健行迷你穿皮腎石切除术 (迷你PCNL) 提供了一种明显更好的无石石率,用于1至2厘米低的卵结石. 这两种治疗方法的住院时间和并发症率都相当.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 腎石病的治療方法
背景情况:
- 结石,特别是那些在下中测量1-2厘米的结石,构成了重大的临床挑战.
- 灵活的尿道镜检查 (f-URS) 和无管的门诊迷你穿皮瘤切除术 (迷你PCNL) 是已确立的最少侵入性治疗选择.
- 关于它们对较低石的疗效和安全性的比较数据对于指导临床决策至关重要.
研究的目的:
- 为了比较f-URS和门诊无管迷你PCNL的安全性和有效性.
- 为了评估治疗1-2厘米下方状结石的结果.
- 评估这两种手术的无结石率 (SFR) 和并发症概况.
主要方法:
- 一项随机对照试验包括72名患有1至2厘米下方状结石的患者.
- 患者接受了f-URS或门诊无管迷你PCNL的治疗.
- 评估的结果包括手术时间,住院时间,SFR (在POD1和3个月),并发症.
主要成果:
- 与f-URS相比,门诊无管迷你PCNL在术后第一天 (50%对11.1%) 和3个月后续 (72.2%对37.1%) 显示出显著更高的SFR.
- 迷你PCNL的手术时间明显更长,但住院时间相似 (5小时与4小时).
- 两组之间没有观察到术后并发症的显著差异;5.7%的f-URS患者需要重新治疗.
结论:
- 门诊无管迷你PCNL和f-URS都对1-2厘米下方的囊结石有效.
- 与f-URS相比,Mini-PCNL提供了更高的无石头率.
- 这些程序表现出可比的住院时间和并发症率,支持迷你PCNL作为实现石头清除的有利选择.
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